UW revision C diff. and irritable

Question 1

Cdiff. Risk factors 5.

Answer 1

Recent abs use or hospitalization
Advanced age > 65
Gastric supression
Underlying IBD
Chemotherapy

Question 2

Cdiff. CP?

Answer 2

Proffuse diarrhea (watery or bloody)
Leukocytosis
Mild abdominal pain
Incr. temp
nausea

Question 3

Cdiff. complications?

Answer 3

Fulminant colitis or toxic megacolon

Question 4

Cdiff. DO STOOL TOXIN (PCR)

Culture - wrong.

Answer 4

.

Question 5

Cdiff. Infection prevention? 3

Answer 5

Hand hygiene with soap and water
Contact isolation
Sporocidal disinfectant (eg bleach)

Question 6

Cdiff. What about abdominal CT?

Answer 6

not usually necessary in cdiff.
Do CT if toxic megacolon or perforation suspected. However, it cannot distinguish if its IBD flare (eg colitis) OR cdiff.

Question 7

Irritable. Symptoms duration?

Answer 7

Abdominal pain >=1d/week x 3 months AND 2 of the folowing:
Linked to defecation (relieved)
Change in stool frequency
Change in stool form

Question 8

Irritable. ALARMING SYMPTOMS? in addition to initial needed symptoms

Answer 8

Age >=50
Rectal bleeding/melena
Fastin diarrhea (eg nocturnal)
Worsening abdominal pain
Family history if inflamatory BD or colon Ca

Question 9

Irritable.
Symptoms + Alarming + diarrhea predominant. NEXT STEP?

Answer 9

CBC
CRP
Stool culture
Celiac disease

if positive -> Tx underlying
If negative –> IBD-D Tx

Question 10

Irritable.
Symptoms + Alarming + constipation predominant. NEXT STEP?

Answer 10

CBC

If normal -> IBD-C Tx
If abnormal –> COLONOSCOPY

Question 11

Irritable. Initial for both?2

Answer 11

Lifestyle modification and soluble fiber (PHYSLIUM)

Question 12

Irritable. What drug for diarrhea?

Answer 12

Loperamide

Question 13

Irritable. What drug for constipation?

Answer 13

Lubiprostone